The Tyranny of Shame

A few weeks ago, I spent about 9 hours in an emergency room trying to figure out whether or not I was having a heart attack.

There are a lot of reasons why I thought it was unlikely I was having a heart attack—I’m only 37, my cholesterol ratio is good, I had a full cardio workup done in 2020 and (aside from a known arrhythmia) I was given a clean bill of health. (Which was a little absurd to be honest, because I was also dealing with a bunch of mysterious chronic illness symptoms at that time, though no one in the regular medical field was about to give me a diagnosis for any of it.) But there were also a lot of reasons to suspect I was having a heart attack: I had chest pain on the left side radiating down my arm and into my back and neck; I experienced shortness of breath with increased activity; and I was nauseous. Those are literally all the major signs of a heart attack in a woman.

These symptoms went on (and off, and on, and off) for two weeks before I finally went to urgent care just to rule out a heart attack. But they could not rule it out, so, ER it was.

And on the whole time I was there, I felt deep shame about having to go in at all.

The thing is, if you Google any two of my symptoms they would have said “seek immediate care” at the top of the search results. But I am so used to having my health concerns ignored and not being believed that I downplayed the seriousness of my symptoms even to myself. And I knew that if I went in with chest pain and was not having a heart attack, I ran the risk of being told I was “just anxious” (which, yes, I was, and if you were experiencing these kinds of shooting pains around your heart you also would be anxious), hysterical, or a hypochondriac.

I was not having a heart attack. They don’t know why I was experiencing those pains, or why they stopped (I have a theory, but that’s not what this post is about).

But what if I had been having a heart attack? What if I had been having a heart attack the previous weekend when the pain first started and I wrote it off as something related to all my other various maladies? What if I had died because I was too ashamed to seek medical help?

The thing is, this is not the first time, and it won’t be the last time, shame has prevented me from seeking care. Shame is what kept me silent after sexual assault. Shame is what kept me in unhealthy relationships and out of therapy (“what do I have to be depressed about?”). Shame has kept me from asking for help in virtually any area of my life. It’s what kept me from pushing my doctor to keep looking for answers when we kept hitting dead-ends. It kept me in denial about my mental health, prevented me from setting healthy boundaries, and what allowed me to live with worsening chronic vertigo for the last 10 years. It seems no amount of Brené Brown Ted Talks can deprogram me from the reflex of shame.

But I’m learning, as with my anxiety, to sit with the shame, acknowledge it, and then question it. It turns out, shame is a good teacher: it shows us what our unconscious beliefs are. I apparently have an unconscious belief that illness is a personal failing, maybe even a moral one–at least for me. Of course, I know that’s not true. It’s not something I consciously believe, but deep inside, somewhere, I think my laundry list of ailments (just look at the language I instinctually use to describe my medical history!) is evidence of laziness, bad choices, and probably just generally not behaving well. It’s also something I would never believe about anyone else–only myself.

I’ve probably already made long, deep, insightful posts on here about the destructive nature of the Puritanical work ethic, and how even those of us raised in non-religious (or even joyfully blasphemous) homes have some version of this software running the background of our minds. I, an anti-authoritarian witch, was shocked to discover it was alive and well inside of me (and ruining my life) when I finally got into regular therapy. But it’s there, buried deep inside most of us, holding hands with the hyper-individualism of the American Dream, isolating us from community support and grinding us into dust.

And here’s another way both shame and American hyper-individualism has manifested in my life: recently, a loved one was diagnosed with stage IV lung cancer, and I have not reached out to a single friend for support. It has been easier to discuss this with near-strangers who will know I’m not asking anything of them than it has for me to tell the people I’m close with. I’m not ashamed of the person who is sick (and would I be ashamed if it was me? I’m not sure. Cancer is somehow “different” from other illnesses), rather there is some part of me clenched so tightly around the “freedom” of individualism that asking for support feels like I would be infringing upon the happiness of the people I call my friends, while at the same time putting too much of my emotional safety into their hands. I don’t want to ask anything emotionally taxing from anyone. How shameful, to not be able to carry the burdens of an entire lifetime all by yourself, American individualism says.

(And yet, here I am, posting this information to the internet. Sorry, friends, if you are reading this, and feeling slighted by hearing this news this way–it’s not you, it’s me.)

As usual, I don’t really know the point of this post. It’s a blog post–barely more substantial than a diary entry. I don’t polish these posts; they are pretty raw. I suppose, based on the title, I wanted to say something profound about not letting shame influence our decisions or keep us from seeking/receiving the care and support we need. But that’s so, so much easier said than done. For instance, even after publicly acknowledging all of this, I am still not planning to reach out to friends for support.

Maybe, for now, it’s enough to just become aware of when shame is rearing its loud, mean, stupid head. “Knowing there’s a trap is the first step in evading it,” as my man Frank Herbert once said (yes, I’m quoting DUNE, get used to it).

Here’s a picture of Nadja to make this post a bit happier.

PS: Hopefully my next blog post will have some bangin’ news…I’m just waiting on some paperwork and other official stuff. 😎

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